'What if's' will never end for Indy mom whose son died of opioid overdose

Marion County Superior Judge Bill Nelson and wife Kristy Nelson talk about losing son Bryan Fentz to opioids, their involvement in Drug-Free Marion County and their experience with stigma attached to prescription pill use and addiction.
Jenna Watson/IndyStar

Buy Photo

A photo of Marion Superior Judge Bill Nelson, wife Kristy Nelson and their late son Bryan, seen at their Lawrence home, Indianapolis, Wednesday, Oct. 11, 2017. In 2009, the Nelsons' 20-year-old son died of a prescription-drug overdose. The Nelsons work with drug-free Marion County to educate parents on the dangers of opioids and keeping them in the home.(Photo: Jenna Watson/IndyStar)Buy Photo

She misses the way he asked for grapes after school — with the stems off, please? Even now, Kristy Nelson laughs at the silliness of it all.

She loved that friends teased her teenage son Bryan about being “Mommy’s boy,” and it made her even happier to hear him admit it without reluctance.

He always said she was the reason he went to rehab for the opioid pills he started using his senior year of high school. But ultimately Bryan wasn't spared from the addiction that policymakers now call a nationwide epidemic.

At age 20, Bryan Fentz died from an overdose.

Prescription drugs are killing Hoosiers faster than car crashes and gun homicides combined, according to the Indiana Youth Institute. Fast-tracked on a 15-year incline, 91 Americans die every day from an opioid overdose, the Centers for Disease Control and Prevention reports.

People are addicted to the very medicine designed to cure pain. And it’s probably sitting right now in your medicine cabinet or perhaps laying around.

In Kristy Nelson's home, the pills were in a drawer.

“When we were young we didn’t even think about prescription pills,” Nelson said. “I wasn’t even aware of it, to tell you the truth, that Bryan was even — I always thought he was afraid of stuff like that.”

He was a straight-A student at Ivy Tech Community College, his mom said. She worked at a hospital at the time and his dad was a former police officer. Bryan's stepfather, Bill, is a Marion Superior Court judge within the criminal division.

“I can't believe I missed it under my own roof when I see every day what drugs do to people,” Bill Nelson said. “Eight to 10 cases I deal with are someway related to drugs.”

He keeps a photo of Bryan on his courtroom bench. "Don't put your mom through this hell," he tells defendants.

Bryan's death is a cautionary tale on multiple levels. It serves as a reminder that opioid addiction can devastate any family, and the need to be vigilant about the storage and disposal of prescription pain killers.

Drug dispensaries keep opioids under lock and key, but at home they often sit on the same shelf as the family supply of Tylenol. One in every five high school students has taken prescription drugs without a doctor’s permission, according to the National Youth Behavior Survey.

In Bryan's case, it was a bottle of Vicodin prescribed for Bill Nelson after knee surgery. He only needed enough for two or three days. The rest went in a drawer, seemingly forgotten.

“I think about it all the time,” Kristy Nelson said. “Had I gotten rid of it, I don't know if that would've saved him.”

Buy Photo

Marion Superior Judge Bill Nelson and wife Kristy Nelson photographed at their Lawrence home, Indianapolis, Wednesday, Oct. 11, 2017. In 2009, the Nelsons' 20-year-old son Bryan died of a prescription-drug overdose. The Nelsons work with drug-free Marion County to educate parents on the dangers of opioids and keeping them in the home.(Photo: Jenna Watson/IndyStar)

A flood of prescribed narcotics

At 83.9 prescriptions per 100 people, only 10 states tallied a higher opioid prescription rate than Indiana, according to the most recent CDC data.

One consequence? Families unknowingly possess a powerful narcotic in their house, just waiting to become someone's addiction.

Hoosiers can anonymously get rid of old medications for free Oct. 28 as part of the national drug "Take Back" event sponsored by the Drug Enforcement Administration twice a year. Various drop-off locations include fire stations and the Indiana State Police. More information and locations can be found on the DEA's website.

Pain medication tends not to be discarded because it is often perceived to be safe. It is medication after all, prescribed by a doctor or a dentist. That perception is certainly true among teenagers. In a survey of more than 20 million teenagers, Partnership for Drug-Free America reported that 40 percent think prescription drugs are safer than illegal drugs and 29 percent think opioids aren't addictive.

“Opioids in some individuals make you feel warm and euphoric, and that can happen especially with teens,” said Dr. Joan Duwve, the associate dean for public health practice at the Richard M. Fairbanks School of Public Health at IUPUI. “Addiction can develop quickly even after one use. The developing teen brain can be primed to enjoy the effects of opioids, making it more likely they will misuse in future.”

Bryan's brain was rewired to depend on drugs. And the high he needed was in plain sight. His parents said it is possible he found pills at his grandparents' home — they lived down the street. It was only after he became addicted, that he started hiding pills. Kristy Nelson would sort through her son’s belongings and find pills in shirt pockets, sock drawers and even in Skittles wrappers.

Randy Miller, executive director of Drug Free Marion County, said two things play a major role in drug usage: access and availability. “If someone has that availability to prescription medicine, then the access is opportunity for addiction to occur.”

In efforts to curtail the number of painkiller prescriptions, Gov. Eric Holcomb signed Senate Bill 226 into law this year. The law limits opioid prescriptions to a seven-day supply for first-time users and for patients younger than 18. Patients also are allowed to request a partial prescription.

“There are just way too many opioids being prescribed in our state,” Duwve said.

The influx in available opioids affects youth. A pediatric study examining hospital records from 1997 to 2012 showed a 165 percent increase in opioid poisonings for ages 19 and younger. The number jumps to 205 percent among children 1 to 4 years old.

Dr. Dan Rusyniak, medical director of the Indiana Poison Center, said there are cases where a parent might drop an opioid pill on the carpet and not find it until their toddler accidentally swallows it.

"As there are more and more prescription drugs that are available in people's houses, you're going to significantly increase the probability that a kid finds one,” Rusyniak said.

While over-the-counter painkillers present dangers to curious children, one opioid pill could be fatal, Rusyniak said. Despite the importance placed on childproofing areas such as the kitchen, the same thought is rarely applied to medications.

Research released by the Partnership for Drug-Free Kids found that only 11 percent of chronic pain patients said they worry about someone in their house accessing their medications. And just 42 percent said their prescriptions are stored in areas children cannot access.

From January to September of this year, the Indiana Poison Center recorded 114 cases of opioid exposures among kids younger than 19. Children ages 13 to 19 recorded the highest number at 44, but 1-year-olds were second with 26 cases.

Sometimes all it takes is a bottle of pills thrown in a purse or prescriptions left on the countertop. Kids even manage to find opioids on top of the fridge. The safest place is to keep medications is in locked containers, and pills should be safely disposed of when they are no longer needed.

“I think the issue is not whether it’s less opioids. I think the issue is we need to be prescribing drugs more intelligently, and we need to be doing so knowing the risks,” Rusyniak said. “We need to be educating people what we’re prescribing them.”

However, a majority of chronic and acute pain patients said their doctor or pharmacist did not provide information on how to store or dispose of their medication, the study from Partnership for Drug-Free Kids revealed.

CLOSE

In 2016, there were 83.9 opioid prescriptions written per 100 Indiana residents.
Stephen J. Beard/IndyStar

How to protect loved ones

In response to the growing opioid crisis, the Drug Enforcement Administration started partnering with local law enforcement to hold “Take Back” days twice a year. Since 2010, the event has yielded more than 4,000 tons of collected prescription drugs by encouraging people to turn in unwanted medications.

Last year, Take Back efforts resulted in 450 tons of drugs, the most in the previous 12 years.

“The most important part is its heightened awareness,” said Miller of Drug Free Marion County. “It’s given folks the ‘Here’s why they’re bad and here’s why you want to get rid of them.’ It’s also equally effective at getting rid of the volume of pills.”

Indiana State Police collected 1,245 pounds of prescription drugs from more than 65 locations during the last Take Back event in April. Indianapolis accounted for 88 pounds of the total amount gathered.

The day is a good opportunity to sort through the medicine cabinet and take stock of what you no longer need, Miller said. Often times, people find they have extra opioids if an ill or elderly family member recently died.

The next Take Back event is scheduled from 10 a.m. to 2 p.m. Oct. 28. Indiana State Police and the Indianapolis Fire Department will host collection sites for people to dispose of their drugs.

In addition to Take Back days, various locations throughout Central Indiana accept prescription drugs year-round.

Several Eskenazi Health pharmacies use MedSafe drop boxes. Recently installed, the boxes are secured by two locks, bolted to the floor and supervised by employees throughout the day.

Buy Photo

Eskenazi's MedSafe drop boxes provide a safe, environmentally-friendly means of disposal for unused drugs, including prescription opioids, which could present hazards if left around the home. A drug disposal drop box is seen at Eskenazi Health Center Westside, Indianapolis, Friday, Sept. 29, 2017. (Photo: Jenna Watson/IndyStar)

Signs above the 4-foot tall containers indicate what people can and cannot dispose of. Once the inner lining is filled, the bags are sent to be incinerated.

"It decreases the temptation, decreases the chances of something happening,” said Todd Cox, manager of Eskenazi outpatient pharmacy. “Lot of people are at their parents', their grandparents' house, and they find something and they wonder, ‘I wonder what would happen if I tried this, or I heard about this.’ It decreases the availability and decreases the temptation."

Additionally, the Marion County Sheriff’s Office offers a 24-hour drop box inside the county jail’s lobby on Alabama Street. Anyone can drop off prescriptions, no questions asked.

Bryan's mother and stepfather have played a critical role — in two ways. Coordinating with Drug Free Marion County and Sheriff John Layton, Kristy and Bill Nelson helped start thejail drop box program in 2014. Less than a year later, the site collected more than 565 pounds of discarded medications. Since April 2016, the jail has gathered almost 625 pounds.

Above the box is a plaque with Bryan's name and picture, dedicating the drop box program to his memory.

But the Nelsons also are making a difference by sharing their heartbreak. They work with Drug Free Marion County to tell Bryan's story to students. When they play the recorded 911 overdose call, the group grows silent.

One girl approached Kristy and asked if she was the mom in the recording. She nodded. The girl promised to never put her mom through the same thing.

That is some consolation for a sadness that will never leave.

Nelson says that the same friends that teased Byran about being “Mommy’s boy” now invite her to their weddings. It is hard, she said, thinking about what could have been. Would he have a family? Would she have grandkids?

He used to tease his mom. When she got old, he would get to control the nursing home she would go into. She would laugh and lightly smack him. He was supposed to be here.

“You don’t want to spend Easter, Christmas, birthdays like we do, standing in front of my son’s grave every Christmas morning when the sun comes up,” Nelson said. “I tell parents, ‘Don't think it can't happen to you.’ I never thought in a million years that that’s how I would spend my Christmas mornings. Never.”